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DR. GARY WALTER UPCHURCH OD
NPI 1265433478
Optometrist in Albany, KY

Active since August 10, 2005PECOS EnrolledAccepts Medicare Assignment
127 FOOTHILLS AVE STE 3, ALBANY, KY 42602(606) 387-5612(606) 387-6602 Get Directions Write a Review

NPPES record last updated: December 3, 2019. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Dr. Gary Walter Upchurch Od NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. GARY WALTER UPCHURCH OD (NPI 1265433478) is an individual optometrist in Albany, Kentucky, licensed in Kentucky (929DT) and active in the NPI registry since August 2005. He is enrolled in Medicare PECOS, maintains a secondary practice location in Russell Springs, and is a graduate of Southern College Of Optometry (1980).

NPPES Registry Identity

NPI1265433478
Entity TypeIndividualMale
Primary Taxonomy152W00000X
Provider Legal NameDR. GARY WALTER UPCHURCHCredential: OD
Location Address127 FOOTHILLS AVE STE 3Albany, KY 42602-1037
Mailing AddressPo Box 306Ferguson, KY 42533-0306 · (606) 492-2211 · Fax (606) 676-0873
Phone(606) 387-5612
Fax(606) 387-6602
Sole ProprietorNo
Medical School CMSSouthern College Of OptometryGraduated 1980
Enumeration DateAugust 10, 2005
Last NPPES UpdateDecember 3, 2019
✔ NPI 1265433478 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers
Taxonomy Code152W00000X
Licenses✔ Licensed in KY · 929DT✔ Licensed in TN · OD2197
Definition
Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.
127 FOOTHILLS AVE STE 3, Albany, KY 42602
Open in Google Maps ↗

Secondary Practice Location 1

Location 1546 Steve DrRussell Springs, KY 42642-4601 · Phone (270) 866-3177 · Fax (270) 866-3155

Other Identifiers 7

Other4627KY · Avesis/medicaid
Medicaid7100209970KY
Medicaid77009298KY
Other01047034Amerigroup
Other3068022Bcbstn/bluecare/tenncare
Other410003588KY · Railroad Medicare
Medicaid4599126TN

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter Health, Ambetter of Tennessee and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Gary Walter Upchurch Od is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID345346847
PECOS Enrollment IDI20100616000163, I20211203001349
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Gary Upchurch reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Associates In Eye Care, Inc.
Same address
Optometrist
127 FOOTHILLS AVE, SUITE 3
Albany, KY 42602
  • Reassigned Medicare billing, Kentucky and Tennessee enrollments
  • Also billed through NPI 1679664304 (Tennessee)
  • 10 clinicians in this Medicare group
NPI 1720190101 (606) 387-5612

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 9

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Removal of cataract with insertion of prosthetic lens 66984
This is a procedure where a cloudy lens in your eye, known as a cataract, is removed. After removal, a clear artificial lens is inserted. This helps to restore your vision, enabling you to see clearly again.
2,231 services18 patients
Established patient problem focused exam of visual system 92012
This is a routine check-up for existing patients focusing on the visual system. It involves examining your eyes to detect any potential issues or changes in your vision. It's a crucial part of maintaining good eye health.
271 services152 patients
Established patient complete exam of visual system 92014
An established patient complete exam of the visual system involves a thorough check of your eyes and vision. It assesses eye health, checks for diseases, and measures your ability to see clearly at different distances. It's a routine, non-invasive procedure.
237 services232 patients
Exam of visual field with extended testing 92083
An extended visual field exam is a detailed test to evaluate your peripheral (side) vision. It helps to detect any potential blind spots which may not be noticeable in daily life. These could be caused by eye diseases like glaucoma, or neurological conditions.
164 services139 patients
Imaging of retina 92134
Imaging of the retina is a non-invasive procedure that captures detailed images of your eye's interior. This helps detect conditions like macular degeneration or retinal detachment. It's painless and takes only a few minutes.
135 services99 patients
Photography of the retina 92250
Photography of the retina, also known as retinal imaging, is a non-invasive procedure that captures images of the back of your eye. This helps doctors identify and monitor conditions like glaucoma, macular degeneration, or diabetic retinopathy. It's painless and quick, often part of a routine eye exam.
77 services75 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 42602 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$122.77 typical visit price
range $52.76 – $162.27
Typical copayment $30.69 (range $13.19 – $40.56)
Most-billed visit code 99204
Established Patient
$66.24 typical visit price
range $16.53 – $131.99
Typical copayment $16.56 (range $4.13 – $32.99)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

Diabetes: Eye Exam
Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period
100%41 patients5/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
47%312 patients1/55-star benchmark: 100%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
100%121 patients5/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
46%668 patients2/55-star benchmark: 99%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
60%668 patients3/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Gary Upchurch's NPI number?

The NPI number for Gary Upchurch is 1265433478. It was assigned to this individual provider in the NPPES registry on August 10, 2005.

Where is Gary Upchurch located?

Gary Upchurch practices at 127 Foothills Ave Ste 3, Albany, KY 42602. The listed phone number is (606) 387-5612.

What is Gary Upchurch's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Is Gary Upchurch enrolled in Medicare?

Yes. Gary Upchurch is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Gary Upchurch's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Gary Upchurch reassigns Medicare benefits to Associates In Eye Care, Inc. (Albany, KY). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Gary Upchurch's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Gary Upchurch accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter of Tennessee, Anthem Blue Cross and Blue Shield and Blue Cross Blue Shield of Wyoming and 6 other insurers list Gary Upchurch as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Gary Upchurch was last updated on December 3, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.